TY - JOUR
T1 - Real-world implementation evaluation of an electronic health record-integrated consumer informatics tool that collects patient-generated contextual data
AU - Holt, Jeana M.
AU - Spanbauer, Charles
AU - Cusatis, Rachel
AU - Winn, Aaron N.
AU - Talsma, Akke Neel
AU - Asan, Onur
AU - Somai, Melek
AU - Hanson, Ryan
AU - Moore, Jennifer
AU - Makoul, Gregory
AU - Crotty, Bradley H.
N1 - Publisher Copyright:
© 2022 Elsevier B.V.
PY - 2022/9
Y1 - 2022/9
N2 - Objective: Use the RE-AIM framework to examine the implementation of a patient contextual data (PCD) Tool designed to share patients’ needs, values, and preferences with care teams ahead of clinical encounters. Materials & Methods: Observational study that follows initial PCD Tool scaling across primary care at a Midwestern academic health network. Program invitations, enrollment, patient submissions, and clinician views were tracked over a 1-year study period. Logistic regression modeled the likelihood of using the PCD Tool, accounting for patient covariates. Results: Of 58,874 patients who could be contacted by email, 9,183 (15.6%) became PCD Tool users. Overall, 76% of primary care providers had patients who used the PCD Tool. Older age, female gender, non-minority race, patient portal activation, and Medicare coverage were significantly associated with increased likelihood of use. Number of office visits, medical issues, and behavioral health conditions also associated with use. Primary care staff viewed 18.7% of available PCD Tool summaries, 1.1% to 57.6% per clinic. Discussion: The intervention mainly reached non-minority patients and patients who used more health services. Given the requirement for an email address on file, some patients may have been underrepresented. Overall, patient reach and adoption and clinician adoption, implementation, and maintenance of this Tool were modest but stable, consistent with a non-directive approach to fostering adoption by introducing the Tool in the absence of clear expectations for use. Conclusion: Healthcare organizations must implement effective methods to increase the reach, adoption, implementation, and maintenance of PCD tools across all patient populations. Assisting people, particularly racial minorities, with PCD Tool registration and actively supporting clinician use are critical steps in implementing technology that facilitates care.
AB - Objective: Use the RE-AIM framework to examine the implementation of a patient contextual data (PCD) Tool designed to share patients’ needs, values, and preferences with care teams ahead of clinical encounters. Materials & Methods: Observational study that follows initial PCD Tool scaling across primary care at a Midwestern academic health network. Program invitations, enrollment, patient submissions, and clinician views were tracked over a 1-year study period. Logistic regression modeled the likelihood of using the PCD Tool, accounting for patient covariates. Results: Of 58,874 patients who could be contacted by email, 9,183 (15.6%) became PCD Tool users. Overall, 76% of primary care providers had patients who used the PCD Tool. Older age, female gender, non-minority race, patient portal activation, and Medicare coverage were significantly associated with increased likelihood of use. Number of office visits, medical issues, and behavioral health conditions also associated with use. Primary care staff viewed 18.7% of available PCD Tool summaries, 1.1% to 57.6% per clinic. Discussion: The intervention mainly reached non-minority patients and patients who used more health services. Given the requirement for an email address on file, some patients may have been underrepresented. Overall, patient reach and adoption and clinician adoption, implementation, and maintenance of this Tool were modest but stable, consistent with a non-directive approach to fostering adoption by introducing the Tool in the absence of clear expectations for use. Conclusion: Healthcare organizations must implement effective methods to increase the reach, adoption, implementation, and maintenance of PCD tools across all patient populations. Assisting people, particularly racial minorities, with PCD Tool registration and actively supporting clinician use are critical steps in implementing technology that facilitates care.
KW - Consumer Health Informatics
KW - Health Information Technology
KW - Implementation Science
KW - Patient-Centered Care
KW - Professional-Patient Relations
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U2 - 10.1016/j.ijmedinf.2022.104810
DO - 10.1016/j.ijmedinf.2022.104810
M3 - Article
C2 - 35714549
AN - SCOPUS:85131956770
SN - 1386-5056
VL - 165
JO - International Journal of Medical Informatics
JF - International Journal of Medical Informatics
M1 - 104810
ER -